Reinhart Katelyn M, Cortez Melissa M, Martindale Cecilia, Moskatel Leon S, Urry J Gary, Ahmed Zubair A, Newman Anna, Pham Kendra, Bartell Jared, Schwedt Todd, Aurora Sheena, Digre Kathleen B, Baggaley Susan K, Brennan K C
medRxiv. 2025 Aug 13:2025.08.09.25333153. doi: 10.1101/2025.08.09.25333153.
Headache is a common consequence of ascent to high altitudes, and acute mountain sickness shares many features with migraine. Evidence also suggests that the prevalence of migraine is increased in people living at both high and moderate elevations. Here we identify an increased occurrence of migraine aura with increasing elevation. Our findings are supported by multiple lines of clinical evidence including a chart review characterizing the phenotype, a systematic prospective cohort comparison between moderate and low elevation, cross-sectional data from a multicenter headache clinic registry, and a nationwide electronic medical record-based dataset. In data from mice housed in altitude chambers, we show that susceptibility to spreading depolarization is increased with simulated elevation, providing a candidate mechanism for the altitude phenotype. The increased susceptibility to aura and SD with elevation may provide a unique opportunity to develop targeted strategies for mitigation relevant to the nearly 1 billion people worldwide living at higher elevations worldwide.
头痛是攀登到高海拔地区的常见后果，而急性高山病与偏头痛有许多共同特征。有证据还表明，生活在高海拔和中等海拔地区的人群中偏头痛的患病率有所增加。在此，我们发现随着海拔升高，偏头痛先兆的发生率增加。我们的研究结果得到了多方面临床证据的支持，包括对表型进行特征描述的图表回顾、中等海拔与低海拔之间的系统前瞻性队列比较、多中心头痛诊所登记处的横断面数据以及基于全国电子病历的数据集。在置于海拔舱中的小鼠数据中，我们表明随着模拟海拔升高，对扩散性去极化的易感性增加，这为海拔表型提供了一种候选机制。随着海拔升高对先兆和扩散性去极化的易感性增加，可能为制定针对全球近10亿生活在较高海拔地区人群的缓解策略提供独特机会。
